BP in Patients with Chronic Kidney Disease: Do the Usual Targets Apply?

Observational data suggest an increase in mortality risk at diastolic pressures less than 70 mm Hg, even when systolic pressure is elevated.

Optimal blood pressure (BP) is uncertain in patients with chronic kidney disease (CKD), which is often associated with high pulse pressure. These investigators examined BPs and outcomes in 651,749 U.S. veterans with non–dialysis-dependent CKD (mean age, 74; 88% white; 9% black) treated at Veterans Affairs healthcare facilities from October 2004 through September 2006. At baseline, 43% of participants had diabetes, and mean glomerular filtration rate was 50.4 mL per minute; mean baseline systolic BP (SBP) and diastolic BP (DBP) were 135 mm Hg and 72 mm Hg, respectively.

During a median follow-up of 5.8 years, 238,640 patients died. The associations of both SBP and DBP with mortality were U-shaped. Optimal SBP was in the approximate range of 1…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

BP in Patients with Chronic Kidney Disease: Do the Usual Targets Apply?

Topics

Reviewing Author